Indications for pancreas-kidney transplantation i. Type 1 diabetes mellitus with end-stage renal failure (uremia) is the standard indication for combined pancreas-kidney transplantation. Diabetes mellitus complicated with end-stage renal disease is mostly accompanied by other complications of diabetes mellitus, such as diabetic retinopathy and glucose? uropathy neuropathy. At this time, pancreas transplantation is not only for the prevention of advanced diabetic syndrome, but also, and more importantly, for the treatment of diabetic end-stage renal disease by Li Chao of the All-Army Organ Transplantation Institute of the No. 309 Hospital of the People’s Liberation Army (PLA). However, the long-term effect of kidney transplantation alone is not good, so diabetic patients who need kidney transplantation are suitable patients for pancreas-kidney combination transplantation. Pancreas-kidney combination transplantation is usually chosen for diabetic patients with uremia who are already on dialysis. Patients with serum creatinine of 300-500μmol/L who are not on dialysis are in good condition, tolerate the operation well and recover faster after transplantation. Patients with diabetes mellitus who have already undergone kidney transplantation, if the transplanted kidney functions well and there is no complication after surgery, they need pancreas transplantation to further prevent the occurrence of diabetes mellitus complications, interrupt the process of diabetes mellitus, and prevent diabetes mellitus from causing damage to the transplanted kidney. Patients with type 2 diabetes mellitus with uremia who need insulin. Contraindications to pancreas-kidney transplantation I. Absolute contraindications 1, systemic active infection (including tuberculosis) 2, untreated ulcer disease 3, active hepatitis 4, untreated or untreated malignant tumors for less than 1 year after cure 5, HIV-positive patients 6, refractory cardiac failure or left ventricular ejection fraction <30% 7, recent myocardial infarction 8, respiratory insufficiency 9, peripheral limb necrosis, bed-ridden 10, severe gastrointestinal immunopathy, can not take immunosuppressive drugs 11, with psychiatric or psychological abnormalities, or poor compliance 12, smokers, alcoholics or drug addicts 2, relative contraindications 1, age <18 years old or >60 years old 2, recent retinal hemorrhage, 3, symptomatic cerebral vascular or peripheral vascular disease, 4, excessive obesity or more than 150% of the standard body weight 5, positive hepatitis B surface antigen or Hepatitis C antibody positive with normal liver function 6. Serious vascular lesions 7. Pre-cancerous lesions 3. Contraindications to pancreatic fluid bladder drainage style: 1. Uncured urinary tract infection; 2. Lower urethral stenosis; 3. Neurogenic bladder voiding dysfunction caused by advanced damage of diabetes mellitus, bladder contracture or dilatation of bladder, and residual urine measurement of the bladder is greater than 100 ml. Notes for pancreas-kidney co-transplantation recipients 1. After taking anti-rejection medicine for a long time, patients’ resistance is lower than that of ordinary people, so they should avoid exertion, staying up late and getting cold, so as not to induce colds, lung infections, elevated blood pressure and other illnesses. 2. Diet: Eat regularly, with enough vegetables and fruits, eat easy-to-digest food, eat less starchy food such as rice, noodles, potatoes, sweet potatoes, etc. Avoid oily and greasy food, drink and eat, and excessive satiety, so as not to aggravate the burden of transplanted pancreas, indigestion, diarrhea, etc. Avoid too spicy food. Pay attention to drink more water. 3. Prohibit smoking and liquor, and drink high quality red wine in moderation. 4. Participate in appropriate physical exercise as far as possible to enhance the physical quality. 5. Measure weight and fasting finger blood sugar 1~2 times a week. 6, daily measurement of blood pressure, should maintain ideal blood pressure or normal blood pressure. Normal blood pressure: <130/85 mmHg, ideal blood pressure: <120/80 mmHg. Grade 1 hypertension: 140~149/90~94 mmHg (140~149/90~94 mmHg is the critical hypertension) Grade 2 hypertension: 160~179/100~109 mmHg Grade 3 hypertension: ≥180/110 mmHg. Review the following items: 1) Blood and urine routine 2) Fasting blood glucose 3) Liver function: alanine aminotransferase (ALT), azelaic aminotransferase (AST), total protein, albumin, total bilirubin, direct bilirubin 4) Total cholesterol (T-Chol), triglyceride (TG) 5) Renal function: creatinine, urea nitrogen, uric acid (UA) 6) FK506 FK506 trough or CsA trough and peak Within 3 months, weekly, after 3 months, every 2 weeks, after half a year, every 2-3 weeks, after 1 year, monthly, after 2 years, every 1-2 months 7) Oral glucose tolerance, insulin release, C-peptide release, and glycated hemoglobin 6 months and 1 year after surgery, and annually thereafter 8) Anti rejection medications Excessive dosage may cause certain toxicity, side effects and various kinds of infections, while insufficient dosage may cause rejection. The dosage must be adjusted according to the concentration of the drug under the guidance of the doctor, and patients should not increase or decrease the dosage of the drug or stop taking the drug on their own. 9, need to buy drugs through the regular way, so as not to buy fake drugs, resulting in adverse consequences. If you feel unwell, consult a doctor in time to avoid delaying your condition.